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Gastrointestinal > Brain To Gut, Gut To Brain Signalling > Flashcards

Brain To Gut, Gut To Brain Signalling Flashcards

1
Q

What is the role of afferent neurones?

A

Signal from gut to brain

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2
Q

What is the role of efferent neurones?

A

Signal from brain to gut

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3
Q

What are the autonomic neurones of GI tract?

A

Vagal (parasympathetic) efferents - act via enteric neurones

Sympathetic efferents - act on blood vessels and enteric neurones

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4
Q

What do enteric neurones do?

A

Control motility, secretion, blood flow, mucosal growth

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5
Q

What does gastric distension stimulate?

A

Mechanoreceptors

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6
Q

What do intestinal nutrients stimulate?

A

Hormone, paracrine mediators

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7
Q

What is secreted in the inter digestive period?

A

Ghrelin

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8
Q

What do the mechanoreceptors and nutrients and paracrine mediators stimulate?

A

Vagal afferents to brain

Out of brain vagal efferents

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9
Q

What is stimulated down the vagal efferents?

A

Decrease gastric emptying
Increase pancreatic secretion
Increase gastric secretion
Increase gut immune responses

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10
Q

What are the 3 phases of gastric acid secretion?

A

Cephalic, gastric, intestinal

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11
Q

What happens in cephalic phase?

A

Release of acetylcholine and gastric releasing peptide

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12
Q

What happens in the gastric phase?

A

Release of gastrin

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13
Q

What happens in intestinal phase?

A

Release of inhibitory factors

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14
Q

What is the role of the greater T5-T9 splanchnic nerves?

A

Ganglion - celiac
Viscera - foregut
Region of referred pain - epigastric

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15
Q

What is the role of the lesser T10/T11 splanchnic nerves?

A

Ganglion - superior mesenteric
Viscera - midgut
Region of referred pain - periumbilical

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16
Q

What is the role of the least T12 splanchnic nerves?

A

Ganglion - aortico-renal
Viscera - kidneys
Region of referred pain - lower thoracic

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17
Q

What is the role of the lumbar L1/L2 splanchnic nerves?

A

Ganglion - inferior mesenteric
Viscera - hindgut
Region of referred pain - hypogastric

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18
Q

What are 2 types of nociception?

A

Hyperalgesia and allodynia

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19
Q

What is hyperalgesia?

A

Increased response to painful stimulus

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20
Q

What is allodynia?

A

Painful response to a normal innocuous stimulus

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21
Q

What are 2 types of acid peptic related pain?

A

Heartburn and peptic ulcer

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22
Q

What is heartburn?

A

Reflux of acid into oesophagus

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23
Q

What is distension?

A

Mechanoreceptor responses to stretch above ‘threshold’

24
Q

What is satiety?

A

Fullness that persists after eating

25
Q

What is satiation?

A

Prompts the termination of eating

26
Q

What controls food intake?

A

Satiation - amount consumed at one sitting

Satiety - length of time until next occasion

27
Q

What are enteroendocrine cells?

A

Largest endocrine organ in body
Approx 12 cell types
Many respond to nutrients

28
Q

What are nodose ganglion?

A

Vagal afferent neurones
Express receptors for many gut hormones
Receptors transported from cell soma to peripheral

29
Q

What kind of receptors are there in nodose ganglion?

A

CCK receptors

30
Q

Where is GLP-1 released?

A

L-cells

31
Q

What increases / suppresses GLP-1 secretion?

A

Increase in macronutrients
Increase in bariatric surgery
Decrease somatostatin
Decrease calorie restriction

32
Q

What is the GLP-1 receptor?

A

GLP-1R

33
Q

What is the site of action from GLP-1 thought to mediate effects on food intake?

A

Vagus; brainstem; hypothalamus

34
Q

What is the role of GLP-1 in body weight regulation?

A

Increases satiation and satiety, potentiates insulin release

35
Q

Where is ghrelin released?

A

Gastric mucosa

36
Q

What increases / suppresses ghrelin secretion?

A

Circadian rhythms ;

Increase by lack of sleep, increase by calorie restriction, decrease by macronutrients, decrease by bariatric surgery

37
Q

What is the ghrelin receptor?

A

GHS-R1a

38
Q

What is the site of action of ghrelin thought to mediate effects on food intake?

A

Vagus; brainstem; hypothalamus

39
Q

What is the role of ghrelin in body weight regulation?

A

Meal initiator; long term regulator of body weight

40
Q

Where is CCK released?

A

Proximal small intestine I cells

41
Q

What factors increase or suppress secretion of CCK?

A

Increased by fat and protein rich chyme, increased by coffee, decreased by bile acids

42
Q

What is the CCK receptor?

A

CCK1

43
Q

What is the site of action of CCK thought to mediate effects on food intake?

A

Vagus; brainstem; hypothalamus

44
Q

What is the role of CCK in body weight regulation?

A

Increases satiation

45
Q

What is the role of cck?

A

Regulator of small intestine digestion and integrator of brain and gut function

46
Q

What does CCK stimulate?

A

Pancreatic enzyme secretion, gall bladder contraction ( for release of bile into SI to digest lipids )

47
Q

What does CCK inhibit?

A

Inhibits foo intake and gastric emptying, via vagal afferent neurons ( thereby delaying nutrient delivery to small intestine )

48
Q

What happens to vagal afferent neurons during obesity?

A

Insensitive to CCK so does not inhibit food intake and gastric emptying

49
Q

What is the role of GLP-1?

A

Regulator of nutrient utilisation, integrator of brain and gut function

50
Q

What does GLP-1 stimulate?

A

Insulin secretion

51
Q

What does GLP-1 inhibit?

A

Inhibits food intake and gastric emptying, via vagal afferent neurons (thereby delaying nutrient delivery to small intestine)

52
Q

What occurs during GLP-1 based therapy?

A

DPV-IV inhibitors delay GLP-1 breakdown, GLP-1 analogues mimic the effect of GLP-1

53
Q

What is the role of ghrelin?

A

Stimulator of nutrient intake, integrator of gut and brain function

54
Q

When is secretion of ghrelin highest?

A

Highest in blood immediately before a meal

55
Q

What does ghrelin stimulate?

A

Food intake and gastric emptying

56
Q

Where are ghrelin receptors expressed?

A

Expressed on vagal afferent and hypothalamic neurones

57
Q

What does ghrelin inhibit?

A

Actions of CCK on vagal afferent neurones

Gastrointestinal (11 decks)

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